Home Health Care: When Speech Therapy is Needed Part 2

Sometimes a patient will have a hearing or vision loss, coupled with an old stroke or Parkinson’s disease and now there are memory problems. Sometimes these are people who live alone, perhaps with family not living in the area. A nurse, physical therapist or occupational therapist currently seeing the patient may notice during the course of a few appointments that the person seems to be having some difficulties.

Their speech may not be a concern but the person is having problems handling the bill paying, trouble making phone calls, remembering appointments or recalling information previously explained. A referral is then made to the speech-language pathologist for a more detailed assessment.

These types of referrals are increasing and I am always grateful that they needed home health care because this person could have slipped through the cracks for a few more months or years until a more serious problem developed. A geriatric assessment might be an appropriate referral or a driving evaluation that includes reaction time, cognitive functioning and a road test. A key part of the home health care process is to work with all of the disciplines involved as well as the family members and to alert the physician to situations that might involve this person’s safety and quality of life.

Some of those with problems in communication might benefit from a communication device. Several years ago I had a patient who would try and talk, get so frustrated trying to say the words she needed and would give up. But she had good comprehension skills and could spell fairly well so she was a great candidate for a communication device. Although she takes it everywhere with her, this lady will try and communicate verbally first but if she is having problems, she does not hesitate to type the message. One of my ALS patients still had use of his hands but his speech was now totally unintelligible. A major problem was answering the phone. We got a similar communication device on loan from the the local ALS chapter and we decided that he would let the answering machine get the message. Once he had listened to it, he would type the answer or comments on his device, call the person and then play his response. His friends and family learned how to best use this system to maximize their connection for many months providing him with a better quality of life.

The role a speech-language therapist encompasses many different areas that are important to everyday life. Frequently I am seeing a patient with problems in swallowing, for example, and the patient or caregiver has a hearing loss. Providing them with strategies to reduce the frustrations of all involved often makes quite a difference in the day to day conversations.

I am excited to have the opportunity through the articles I am writing for ElderCarelink and the blogs related to those topics to provide you a perspective on how to support a person, whether they are older or younger, through their journey of communication challenges. Not only am I coming from the perspective of a speech-language pathologist but as a daughter whose mother had the challenges of hearing loss, vision impairment, and memory concerns during the last decade of her life. Articles with additional information – Maximizing Your Home Health Care Experience Part 1Part 2.